Individual
ANDREA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4115 W ADAMS ST, CHICAGO, IL 60624-2702
(773) 885-9700
(773) 533-6288
Mailing address
4115 W ADAMS ST, CHICAGO, IL 60624-2702
(773) 885-9700
(773) 533-6288
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
178012148
IL
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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